When you think about dangerous viruses, gonorrhea doesn’t usually come to mind – but that may well be about to change. Gonorrhea, a sexually transmitted disease (STD), has become resistant to most of the antibiotics that we have used to combat it over the last three decades.

We’ve written before about antibiotic resistant gonorrhea entering the US, and about new treatments developed by scientists; but the truth is, the virus is mutating much faster than researchers can keep up – and it’s not their fault. The strain of gonorrhea infecting people today is different than that which occurred 30 years ago. Heck, it’s different from the one from 10 years ago! Add in the fact that it takes, on average, 10-15 years to fully develop a new treatment,

Traditional penicilines and tetracyclines stopped working a while ago against the more virulent strains, and today’s patients have very limited options left. The US Center for Disease Control (CDC) thinks that emerging resistant strains are slowly but surely taking all the options away; the last line of defense is currently a cephalosporin injection combined with an oral dose of either azithromycin or doxycycline. The government agency outlined how things are likely to go when that starts failing too.

By analyzing long-term surveillance data for 17 US cities between 1991 and 2006, researchers were able to trace how gonorrhea became resistant to ciprofloxacin, an antibiotic that lost its CDC recommendation in 2007 because studies demonstrated that 13.8 percent of patient samples were resistant to the drug. The thing is, even though the results of the study are extremely worrying, they are not really that surprising. So, let’s put some numbers down here.

The CDS estimates that if 10 percent of gonorrhea samples are resistant to the recommended treatment, then there will be a subsequent 7 percent increase in gonorrhea. In the United States alone, there are 820,000 cases diagnosed each year, so this translates into 57,400 additional cases – and all of them extremely hard to treat; oh, and this number will increase progressively year after year.

“Based on the experience with other drugs previously used to treat gonorrhea,” said Sarah Kidd, a medical epidemiologist at the CDC who did not participate in the study – “the emergence and spread of cephalosporin-resistant gonorrhea in the United States appears imminent.”

But the virus is already adapting, as “the dose of cephalosporins required to stop gonorrhea from growing has increased.” The thing is that so far, “no resistant cases have been identified in the United States ” – but cases have been reported in other countries, such as Japan, France and Spain. However, there are no clear recommended treatment options for patients who have a cephalosporin-resistant infection, Kidd explained. Researchers are working, but a broader strategy will be needed if we want to keep the edge on the virus – hopefully, we will be able to do it in time.